Cyst Flashcards
Phases of growth of inflammatory cyst?
- initiation phase
- Cyst formation phase
- cyst enlargement phase
Growth factors in initiation phase are produced by …..
Stromal cells of granuloma
Factors other than pressure causes bone resorption in inflammatory cyst?
-stromal cells of granuloma produce
Interleukin
Prostaglandin
Proteinases
Xray of inflammatory cyst?
-RO margin is continuous with lamina dura
-long standing : displacement of neighbouring roots rarely resorbed
While affected tooth is resorbed
A.S.S. of inflammatory cyst?
- 3rd to 6th decade
- males are more
- ant max then post max then post mand then ant max
D.d. of inflammatory cyst
Periapical granuloma, periapical scar, odontogenic tumors,
giant cell lesion. o Early stage of periapical cemental dysplasia.
D Traumatic bone cyst.
Paradental cyst definition etiology and location ?
It is an inflammatory cyst that develops on lateral surface of tooth root.
Result from inflammation of the
gingiva over an erupting molar.
➤ Associated with partially erupted 3rd molar.
Buccal bifurcation cyst cause?
1- inflammatory reaction during eruption of lower 6 cause inflammation of the follicle creating cyst
2- ectopic enamel on the buccal aspec creating pocket which leads to cyst
A.S.S. of buccal bifurcation cyst
5 to 11y
Lower 6
Bilateral in third of people
Signs & symptoms:
- Buccal pocketing, swelling -
- Foul odor.
III. Slight to moderate tenderness.
Xray of buccal bifurcation cyst?
Well defined unilocular radiolucent area involving buccal furcation area.
Occlusal film is essential to reveal the buccal location with roots tips are directed lingually.
o Single or multiple layers of reactive bone formation as a result of periostitis.
Histology of buccal bifurcation cyst
Non-specific.
of The cyst is lined by non-keratinized stratified squamous epithelium with areas of hyperplasia
A prominent chronic inflammatory cell infiltrate is present in the
surrounding connective tissue wall.
Clinical of dentigirous?
- Age10-30 years.
2
Sex
males > females.
- Affect any unerupted tooth but mainly &-3.
3
4 Deciduous teeth rarely affected & may associate supernumerary tooth. Asymptomatic and discovered when the eruption of tooth is delayed.
6 Large cysts may cause cortical expansion of bone & facial asymmetry. Painful if infected by hematogenous route or PDL disease or
7.
periapical lesion of adjacent tooth
X ray of dentigirous ?
Unilocular radiolucent area on crown of unerupted tooth
with well-defined sclerotic (opaque) border.
o Large cyst may be multilocular radiolucencies.
o If infected →ill-defined border.
CLINICO-RADIOGRAPHIC CLASSIFICATION: (according to relation with tooth)
o Central most common, cyst surround crown attach at CE), o Lateral cyst partially surround crown.
o Circumferential cyst surround crown and enclose a large portion of root
Dentegirous and adjacent roots ?
Resorption
Complications of dentigirous
Patho fracture Root resorption -Mucoepidermoid carcinoma from mucous secreting cells -sq.c.c -ameloblastoma
Dentigerous vs eruption cyst in pedo
Eruption can happen over pedo tooth but not dentigerous it’s too rare
Eruption cyst is called . … due to bleeding in cyst cavity with trauma
Eruption hematoma
Site of eruption cyst?
Ant max
Post mand
Also deciduous
Clinical of gingival cyst of newborn
Less than 2mm
Spontaneous healing
Multiple
More in max than mand
HistoPayhology of gingival cyst of newborn
St sq k epi
Thun epi
Nodular thickening
Epstein pearls
Inclusion non od keratinised cyst at midline of the palate
Gingival cyst of adult ?
- from epi rest of d lamina in ging.
- non k
- non specific histo
- age –5th to 6th
- site – mand pm and c gingiva
- slowly growing painless
- cupping of cortex
- vital adjacent teeth
Lateral periodontal cyst?
Non keratinized developmental odontogenic cyst lateral to root of the tooth within bone.
o Arise from epithelial rest of dental lamina
in bone
- Age 20-60 years.
- Sex males > females.
- Site →more in mandible
(premolar & canine area).
- Painless slowly growing.
- Adjacent teeth are vital.
o Well defined round or tear
drop RL area surrounded by RO margin between 2
adjacent roots.
o Thin non keratinized stratified squamous epithelium.
o Nodular thickening may be
present in the epithelial lining.
o Numerous daughter microcysts may be found in CT wall.
Origin of OKC
Arise from cell rests of dental lamina
Mechanism of its growth is due to: unknown factors
o Vakoown factor inherited in setthelial es
inherent in epi tous.
EnZymatic Activity of fibrous a wall
so it
may be considered as benign cystic neoplasm (named keratocystic odontogenic tumor).
OKC clinical
Age 10-40 years.
- Sex 60-80% of cases in males.
- Sitemandible> maxilla (mainly in posterior part of mandible and ascending ramus).
- If small asymptomatic.
- If large painless or painful.
- Grow in antero-posterior direction (Le. In medullary bone not causing obvious bone expansion). 7. Occasionally parasthesia of the lower lip may be present.
OKC radio picture
R/E:
o Small cysts → usually unilocular, well defined radiolucent area with well-defined radioopaque
margin.
a Large cysts → multilocular radiolucent area.
May be associated with unerupted tooth. o Resorption of adjacent roots may be seen.
Ttt and prog of OKC
- friable ct wall don’t allow removal as one piece
- cautterization with carnoy solution allows separation from bone and decreases recurrence
- bur peripheral osteotomy with reconstruction and graft
- 30%recurrence
- rare carcinoma transformation
Gardner goltz syndrome
Autosomal dominant condition which reveals:
Multiple BCCs.
Multiole odontogenic keratocysts
Bifid ribs.
Broad nasal bridge.
© Mandibular prognathism.
o Frontal bossing.
o Vertebral kyphosis.
o Intracranial calcifications.
o Palmer and plantar pits.
o Ovarian fibromas in females.
o Cleft lip & palate.
Gorlin cyst origin
Reduced enamel epi.
Or remnants of dental lamina
Nature of gorlin cyst
-may be classified as tumor
Ccot
Calcifying cystic od. Tumor
Solid more than cystic
COC site
Ant to 6
Central 75% max than mand in canine and incisors
Peripheral 25% in ging.
Gorlin cyst age and sex
Age less than 40
Female
Gorlin signs
-slowly growing
Painless
Facial asymmetry could be found
Teeth displacement
Xray of COC
-well defined
-multi or uni locular
-displacemnt of roots and resorption
- salt and pepper radioopacities
Scattered
Median mandibular cyst origin
Not fissural May be OKC Lateral pdl cyst Periapical cyst
Origin of globulin max
Lateral pdl
Clinical of globulo max cyst
-bet roots of upper 3 and 2
-rare between 2 and 1
-cortical exp.
-teeth displacement
-
Median mand cyst clinical
- between lower central incisors
- or apical
- slowluly growing painless
Most common non od cyst
Is nasopalatine duct cyst
Cause of nasopalatine duct cyst
-trauma infection or spontaneous
Affecting epi remenant of nasopalatine duct
Clinical of nasopalatine
Age 5th to 6th decade
Female
Any point along NP canal
Fluctuant swelling at bu alv mucosa and ant palate
May be painful
If occurred in incisive papilla is called papilla palatina cyst
Salty discharge and is bluish
-between or apical to roots of central upper I
-
Nasopalatine cyst does it affect roots of upper central
Yes
Divergence may occur
Origin of median palatine cyst
May be fissural
Or posteriorly positioned nasoplalatine duct cyst
Is there pain in med palatine cyst
It starts asymptomatic but pain and expansion may occur
